Emergency departments reluctant to give sick notes

UK government guidance to hospitals on issuing sickness certificates is being ignored at accident and emergency departments and fracture clinics. A survey of 50 hospitals in Scotland and England found that only nine of their emergency departments and 20 fracture clinics issued certificates. Seven hospitals stated it was policy not to do so, and the rest had no clear policy but “just don't give them.” Reasons may include patients assuming that only general practitioners can issue them, reluctance by doctors (who may think they are unnecessary), and a desire not to increase workload. Emergency staff, in particular, may be concerned that patients might attend for that purpose alone. The authors recommend that explicit departmental policies be designed to comply with Department of Health advice, whose 2001 report estimated possible savings of 518 000 general practitioner appointments and 42 000 hours of their time.